Neurological complications post transplant have been described with the use
of calcineurin inhibitors. Although tacrolimus may be a better immunosuppr
essant than cyclosporine, its neurological side effects may be worse. Two c
hildren, living-related kidney trans plant recipients, were treated with an
tibody induction, mycophenolate mofetil, prednisone, and tacrolimus. Soon a
fter transplant, they each developed an encephalopathy, which when visualiz
ed by magnetic resonance imaging showed that it affected both white and gre
y matter of the brain. Although the encephalopathy was associated with the
use of tacrolimus, there was a complete neurological recovery without cessa
tion of the drug.